As was observed at Powerline it is a clinical study of Hayek’s “knowledge problem”—the impossibility of centralizing fundamentally dispersed knowledge in a timely and accurate way. In my opinion it goes to the fundamental flaw in the system. That is that the best medical decisions will be made locally not from a central command.

Additionally the Post article indicates that if the states fail to create exchanges then the federal government is supposed to step in. The problem is that the feds have no more idea than the states on how to do this.

Then again, the future of the law is in doubt from both the supreme court and next years election. How much time and money should be spent on exchanges that are not only unmanageable but may never be utilized?

As Benjamin Zycher said, The federal government does not have patients; it has interest groups.